and pustules, skin tightness, dryness, burning sensation, itching, stinging and stinging test, and local tolerability. Instrumental evaluations included skin hydration and TEWL. Furthermore, subject satisfaction was assessed on days fifteen and thirty. Results of this split-face study supported the significant superiority of MVW serum over the standard skincare regimens, with subjects displaying improvements in erythema, skin tightness, dryness (all P≤0.05), and hydration (P< 0.0001) by day fifteen. The skin stinging test also significantly favored MVW (P< 0.05 at day fifteen and P<0.01 at day thirty). The MVW serum was well tolerated throughout the study, and subject satisfaction was very high.22
These clinical results were supplemented by fundamental research and confirmed earlier studies investigating the efficacy and tolerability of thermal spring water used as monotherapy or adjunctive therapy in rosacea-prone skin.23,24
The first study evaluated MVW serum in thirty-seven women aged 18-45 years treating rosacea-prone skin who applied the test formula as monotherapy twice daily for four weeks. An investigating dermatologist evaluated redness and telangiectasia at baseline, week 4, and one week after discontinuing use. Based on a 10-point visual analogue scale, decreases in redness and telangiectasia severity were significant at week 4, compared to baseline, and maintained after one week of stopping treatment.
In a second clinical study, 550 adult volunteers with rosacea used MVW serum as either monotherapy (n = 117) or adjunctive therapy (n = 433). At baseline and month 2, subjects and the evaluating physician completed questions on tolerance, clinical signs and symptoms, and skin reactivity to triggers. By month 2, investigators reported significant improvements in erythema, telangiectasia, flushes, dryness, and skin tightness. Moreover, investigators noted a reduction in subjects' skin reactivity to triggers (eg, sun, intense physical exercise, heat, wind).
A third study used a randomized, double-blind, vehiclecontrolled design to evaluate sixty-five patients with rosacea who were finishing an eight-week regimen with Metronidazole. After completing the Metronidazole treatment, patients applied the test formula or vehicle twice daily for eight weeks. After week 16, the percentage of patients with global improvement in the signs of rosacea stayed significantly higher in the test group, compared to vehicle. The authors concluded that the thermal spring water helped to prolong the efficacy of the Metronidazole treatment.23
Other clinical studies using MVW serum have confirmed the protective effects of the formulation. For example, an observational study included fifty-two adult females with high rates of extrinsic exposome exposure (eg, pollution, smoke, stress, sleep difficulties) and presented with a "dull" appearance, lacking homogeneous complexion, plumpness, and smoothness. MVW serum was applied to the face, eyes, and lips twice daily for four weeks. Compared to baseline, dermatologist- assessed skin radiance, homogeneity, plumpness, and smoothness had notably improved by week four. Moreover, there were no instances of irritation. The authors concluded that twice-daily MVW serum use on the face, eyes, and lips was shown to be safe and effective.13
In vitro studies have indicated that the use of MVW serum protects skin integrity by acting on the expression of certain proteins (eg, catalase, superoxide dismutase, glutathione peroxidase) that boost the skin's antioxidant defenses.13,23 Furthermore, MVW serum has been shown to stimulate epidermal keratinocyte differentiation and tight junction protein synthesis necessary for reinforcing skin barrier function and skin integrity.25,26 Tacheau et al26 studied the potential effect of MVW on human keratinocyte homeostasis, proliferation, and differentiation. Investigators selected MVW due to its specifically high concentration of mineral cations (specifical calcium). The authors noted that a vast array of biological processes were modulated by MVW, including bone mineralization, hemoglobin activities, and epidermal differentiation.
Overall, MVW's clinical utility may be attributed to its elements, their high concentrations relative to other thermal waters, and its compatible pH level (5.3 +/- 0.3) with that of the SC [(pH = 5.5); Table 3].27-31
These clinical results were supplemented by fundamental research and confirmed earlier studies investigating the efficacy and tolerability of thermal spring water used as monotherapy or adjunctive therapy in rosacea-prone skin.23,24
The first study evaluated MVW serum in thirty-seven women aged 18-45 years treating rosacea-prone skin who applied the test formula as monotherapy twice daily for four weeks. An investigating dermatologist evaluated redness and telangiectasia at baseline, week 4, and one week after discontinuing use. Based on a 10-point visual analogue scale, decreases in redness and telangiectasia severity were significant at week 4, compared to baseline, and maintained after one week of stopping treatment.
In a second clinical study, 550 adult volunteers with rosacea used MVW serum as either monotherapy (n = 117) or adjunctive therapy (n = 433). At baseline and month 2, subjects and the evaluating physician completed questions on tolerance, clinical signs and symptoms, and skin reactivity to triggers. By month 2, investigators reported significant improvements in erythema, telangiectasia, flushes, dryness, and skin tightness. Moreover, investigators noted a reduction in subjects' skin reactivity to triggers (eg, sun, intense physical exercise, heat, wind).
A third study used a randomized, double-blind, vehiclecontrolled design to evaluate sixty-five patients with rosacea who were finishing an eight-week regimen with Metronidazole. After completing the Metronidazole treatment, patients applied the test formula or vehicle twice daily for eight weeks. After week 16, the percentage of patients with global improvement in the signs of rosacea stayed significantly higher in the test group, compared to vehicle. The authors concluded that the thermal spring water helped to prolong the efficacy of the Metronidazole treatment.23
Other clinical studies using MVW serum have confirmed the protective effects of the formulation. For example, an observational study included fifty-two adult females with high rates of extrinsic exposome exposure (eg, pollution, smoke, stress, sleep difficulties) and presented with a "dull" appearance, lacking homogeneous complexion, plumpness, and smoothness. MVW serum was applied to the face, eyes, and lips twice daily for four weeks. Compared to baseline, dermatologist- assessed skin radiance, homogeneity, plumpness, and smoothness had notably improved by week four. Moreover, there were no instances of irritation. The authors concluded that twice-daily MVW serum use on the face, eyes, and lips was shown to be safe and effective.13
In vitro studies have indicated that the use of MVW serum protects skin integrity by acting on the expression of certain proteins (eg, catalase, superoxide dismutase, glutathione peroxidase) that boost the skin's antioxidant defenses.13,23 Furthermore, MVW serum has been shown to stimulate epidermal keratinocyte differentiation and tight junction protein synthesis necessary for reinforcing skin barrier function and skin integrity.25,26 Tacheau et al26 studied the potential effect of MVW on human keratinocyte homeostasis, proliferation, and differentiation. Investigators selected MVW due to its specifically high concentration of mineral cations (specifical calcium). The authors noted that a vast array of biological processes were modulated by MVW, including bone mineralization, hemoglobin activities, and epidermal differentiation.
Overall, MVW's clinical utility may be attributed to its elements, their high concentrations relative to other thermal waters, and its compatible pH level (5.3 +/- 0.3) with that of the SC [(pH = 5.5); Table 3].27-31
LIMITATIONS
Although the exposome as a concept was introduced over
a decade ago, the skin exposome has only recently gained
attention from the scientific community. Given the short
history of research in this field, many keywords were required
to retrieve a small (N = 11) number of relevant articles on the
interplay between the exposome, essential elements, and skin
health. Therefore, more studies are required to confirm the
results of early clinical trials.
CONCLUSIONS
A combination of in vivo, in vitro, and clinical data support
that facial MVW serum application may protect against the
harmful effects of the skin exposome and possibly reduce skin
inflammation. Moreover, clinical trials indicate the benefits
of MVW serum as an adjunct for facial dermatoses and postprocedural
skincare.
DISCLOSURE
All authors received personal fees from L'Oréal during the
conduct of the advisory boards. The authors report no other
